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- Franzen, Lisa, et al.
(author)
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Accuracy of on-site urine drug tests : an experimental study
- 2013
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In: Clinical Toxicology. - : Informa Healthcare. - 1556-3650 .- 1556-9519. ; 51:4, s. 348-349
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Journal article (other academic/artistic)abstract
- Objective: On-site drug tests (ODTs) are frequently used in hospitals to screen the urine of patients admitted for suspected poisoning. The purpose of this study is to evaluate the accuracy of such tests used in emergency departments in Sweden.Methods: Two brands, ColibriCheck™ and Concateno™, were tested for detecting amphetamine, benzodiazepines, opiates and tetrahydrocannabinol (THC) in urine. The results were compared with laboratory screening (CEDIA) and confirmation method (GC-MS). The study was conducted from December 2011 to March 2012 using samples from drug dependence clinics; 400 positive (100 in each drug group) and 200 negative (applied to all drug groups).Results: High specificity (Table 1) implies that most true negative samples are detected, but the risk of missing a true positive sample is high (6–26%). The incidence of false positive test results was low ( 1%). Limitations: inadequate blinding of the analysing procedure, emergency department samples were not included and GC-MS was performed on positive but not negative samples.Conclusion: The implications of this study are that positive ODTs are fairly reliable whereas negative ODTs neglect 6–26% of true drug presence. Consequently patients might be overlooked if treatment depended on the test result. ODTs’ intrinsic problems e.g. cross-reactivity and limited spectrum of analytes1, that are not addressed in our study, could further influence the reliability of test results.Reference1. Krasowski MD, Pizon AF, Siam MG, et al. Using molecular similarity to highlight the challenges of routine immunoassay-based drug of abuse/toxicology screening in emergency medicine. BMC Emerg Med 2009; 9:5.
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- Jones, A Wayne, et al.
(author)
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Toxicological analysis of blood and urine samples from female victims of alleged sexual assault
- 2012
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In: Clinical Toxicology. - : Informa Healthcare. - 1556-3650 .- 1556-9519. ; 50:7, s. 555-561
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Journal article (peer-reviewed)abstract
- Background. The toxicological analysis of blood and urine samples from victims of alleged sexual assault represents a crucial part of the forensic evidence when this crime is investigated. Material and methods. We searched a national forensic toxicology database (TOXBASE) to find cases registered as sexual assault, rape, including date-rape that the police had requested the analysis of ethanol and other drugs. Between 2008 and 2010, N = 1460 such cases met this criteria. After immunological screening of urine or blood samples, all positive results were verified by more specific analytical methods, such as gas chromatography-mass spectrometry (GC-MS) for illicit drugs. A large number of prescription drugs and their metabolites were determined by capillary GC with nitrogen-phosphorous (N-P) detector. GC with flame ionization detector (FID) was used to analyze ethanol and gamma-hydroxybutyrate (GHB) in blood at limits of quantitation (LOQ) of 0.1 g/L and 8 mg/L, respectively. Results. The average age (+/- standard deviation) of all victims was 24 +/- 10.3 years and 72% were between 15 and 29 years. Ethanol and other drugs were not detected in 31% of cases (N +/- 459). Blood-ethanol was positive in N = 658 cases at mean, median and highest concentrations of 1.23 g/L, 1.22 g/L and 4.3 g/L, respectively. Ethanol plus drugs were present in N = 188 cases (13%) and one or more other drugs alone in N = 210 cases (14%). Cannabis (marijuana) and amphetamines were the major illicit drugs, whereas diazepam, alprazolam, zopiclone as well as newer antidepressants were the major prescription drugs identified. Conclusions. The mean age of victims of sexual assault in Sweden, the proportion of drug positive to drug negative cases, the predominance of ethanol positive cases as well as the types of other drugs showed a remarkably good agreement in two studies spanning a period of 8 years.
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